Changes in functional limitations and survival among the elderly in Taiwan: 1993, 1996, and 1999

This paper focuses on changes in the prevalence of functional limitations among nationally representative samples of adults aged 65 and older in Taiwan as measured in 1993, 1996, and 1999. Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties walking and climbing stairs, two tasks that represent basic lower body movements that are less likely to be influenced by changes in living environments and social roles than are activities of daily living and instrumental activities of daily living. Results are shown for both unadjusted prevalence rates and rates adjusted for changes in population composition. Findings indicate that Taiwan does not appear to be experiencing the improvements in functioning that have been witnessed recently in the United States. The prevalence of functional limitation increased between 1993 and 1996 and between 1996 and 1999. One possible reason for the increase in limitation is the change in old-age survival in Taiwan, which appeared over the study period to have benefited those who have functional limitations, especially in a severe form. The country's Universal Health Insurance program, established in 1995, may have increased access to care and thus survival of those in poorest health.